Nokea
A 10-year old child is admitted to the hospital with complications related to chickenpox. The nurse should do which of the following to prevent the transmission of the infection to other children on the unit? Select all that apply.
- A. Place the child on contact isolation.
- B. Wear a gown, mask, and gloves before entering the room.
- C. Place the child in a room with a 10-year-old who has had chickenpox.
- D. Place the child in a negative air-flow room.
- E. Maintain isolation until lesions have disappeared.
Correct Answer: A,B,C,E
Rationale: Chickenpox requires contact and airborne precautions (gown, mask, gloves) and isolation until lesions crust. Rooming with an immune child reduces risk. Negative airflow is for diseases like tuberculosis.
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A 12-year-old client with asthma is receiving I.V. hydrocortisone, ampicillin, and theophylline. The client vomits after breakfast and lunch, is very irritable, and has a heart rate of 120 beats/minute. The nurse should:
- A. Offer small amounts of clear liquids.
- B. Inform the primary health care provider that the child is having an allergic reaction to the ampicillin.
- C. Add the missed dose of theophylline and inform the primary health care provider of the vomiting.
- D. Administer oxygen to decrease the heart rate.
Correct Answer: C
Rationale: Vomiting, irritability, and tachycardia (heart rate of 120 bpm) are signs of theophylline toxicity. The nurse should withhold further doses, inform the provider of the vomiting, and monitor for toxicity, as additional theophylline could worsen symptoms.
A nurse is teaching an 8-year-old with diabetes and her parents about managing diabetes during illness. The nurse determines the parents understand the instruction when they indicate that, when the child is ill, they will provide:
- A. More calories.
- B. More insulin.
- C. Less insulin.
- D. Less protein and fat.
Correct Answer: B
Rationale: Illness increases insulin resistance, often requiring more insulin to manage elevated blood glucose. Calorie, protein, or fat adjustments are secondary to insulin needs.
The nurse is assessing a child with leukemia who is receiving chemotherapy. Which finding indicates a potential complication requiring immediate action?
- A. A temperature of 100.4°F (38°C).
- B. A heart rate of 90 beats per minute.
- C. A platelet count of 150,000/mm³.
- D. A white blood cell count of 5,000/mm³.
Correct Answer: A
Rationale: A fever of 100.4°F in a child on chemotherapy suggests possible infection, a life-threatening complication due to immunosuppression, requiring immediate action.
During hospitalization, a 10-year-old child with acute poststreptococcal glomerulonephritis and oliguria asks for food from home. After teaching the mother and child about diet, the nurse determines that the teaching had been effective when the mother brings in which food?
- A. Pizza and cola.
- B. Hamburger and fries.
- C. Ice cream sundae.
- D. Strawberries and kiwi.
Correct Answer: D
Rationale: Low-sodium, low-protein options are best.
The primary health care provider orders pulse assessments through the night for a 12-year-old child with rheumatic fever who has a daytime heart rate of 120. The nurse explains to the mother that this is to evaluate if the elevated heart rate is caused by:
- A. The morning digitalis.
- B. Normal activity during waking hours.
- C. A warmer daytime environment.
- D. Normal variations in day and evening hours.
Correct Answer: B
Rationale: Elevated heart rate in rheumatic fever may be due to activity, which increases cardiac demand. Nighttime assessments help determine if the rate normalizes at rest, ruling out activity as the cause.